ABSTRACT

Ureteral and renal pelvic tumors are very rare, representing only a small fraction of all genitourinary and renal tumors.

The majority are transitional cell carcinomas.

Risk factors include smoking, aniline dyes, phenacetin abuse, Balkan nephropathy, and cyclophosphamide.

The most common presenting symptoms are hematuria (75% of patients) and flank pain (30%).

Evaluation includes history and physical exam, urinalysis, urine culture and cytology, serum electrolytes and liver function tests, upper urinary tract imaging, and cystoscopy. Some patients may also undergo ureteroscopy.

Treatment options include radical nephroureterectomy with bladder cuff (open or laparoscopic), segmental ureterectomy (for ureteral lesions), and endoscopic resection.

Tumor grade and stage are the most important variables that predict survival.

Intensity of post-treatment surveillance should be tailored to the individual patient according to risk of disease progression.